Out-of-Hours Primary Care Centre, Varnesregionen, Stjørdal, Norway.
Emerg Med J. 2013 Sep;30(9):707-11. doi: 10.1136/emermed-2012-201630. Epub 2012 Sep 14.
Use of specialist healthcare services is increasing.
To evaluate whether alternative healthcare services could reduce the need for admissions to specialist care hospitals.
Prospective observational study of emergency referrals for admission to specialist care.
A single out-of-hours primary care centre (OPCC) in Norway.
Out-of-hours physicians registered their referrals for hospital admission and stated whether the admission could have been avoided given the availability of six other healthcare services.
Of 1083 registered encounters at the OPCC, 152 (14%) were referred for specialist care hospital admission. According to the referring physician, 32 (21%) of these referrals could have been avoided. The most eligible alternatives to such referrals were next-day appointments at a specialist outpatient clinic (11 of 32 referrals), or admission to a community hospital (21 of 32 referrals), or a nursing home (nine of 32 referrals). Respiratory (eight of 32 referrals) and gastrointestinal problems (12 of 32 referrals) were the most common among avoidable admissions.
The use of specialist care hospital admission can be reduced if appropriate alternatives are available.
专科医疗服务的使用正在增加。
评估替代医疗服务是否可以减少对专科护理医院的住院需求。
对专科护理急诊转诊进行前瞻性观察研究。
挪威的一个单设夜间初级保健中心（OPCC）。
夜间医生登记他们的住院转诊，并说明如果有其他六种医疗服务可用，这些住院是否可以避免。
在 OPCC 登记的 1083 次就诊中，有 152 次（14%）被转诊到专科护理医院住院。根据转诊医生的说法，其中 32 次（21%）转诊可以避免。最适合替代这些转诊的选择是专科门诊的次日预约（32 次转诊中的 11 次），或社区医院住院（32 次转诊中的 21 次），或疗养院（32 次转诊中的 9 次）。可避免的住院中，呼吸系统（32 次转诊中的 8 次）和胃肠道问题（32 次转诊中的 12 次）最常见。
如果有合适的替代方案，专科护理医院的住院使用率可以降低。
